Frailty trajectories in community-dwelling older adults during COVID-19 pandemic: The PRESTIGE study

Background Frailty has been recognized as potential surrogate of biological age and relevant risk factor for COVID-19 severity. Thus, it is important to explore the frailty trajectories during COVID-19 pandemic and understand how COVID-19 directly and indirectly impacts on frailty condition. Methods We enrolled 217 community-dwelling older adults with available information on frailty condition as assessed by multidimensional frailty model both at baseline and at one-year follow-up using Multidimensional Prognostic Index (MPI) tools. Pre-frail/frail subjects were identified at baseline as those with MPI score >0.33 (MPI grades 2-3). Frailty worsening was defined by MPI difference between 12 months follow-up and baseline >= 0.1. Multivariable logistic regression was modelled to identify predictors of worsening of frailty condition. Results Frailer subjects at baseline (MPI grades 2-3 = 48.4%) were older, more frequently female and had higher rates of hospitalization and Sars-CoV-2 infection compared to robust ones (MPI grade 1). Having MPI grades 2-3 at baseline was associated with higher risk of further worsening of frailty condition (adjusted odd ratio (aOR): 13.60, 95% confidence interval (CI): 4.01-46.09), independently by age, gender and Sars-CoV-2 infection. Specifically, frail subjects without COVID-19 (aOR: 14.84, 95% CI: 4.26-51.74) as well as those with COVID-19 (aOR: 12.77, 95% CI: 2.66-61.40, p = 0.001) had significantly higher risk of worsening of frailty condition. Conclusions Effects of COVID-19 pandemic among community-dwelling frailer individuals are far beyond the mere infection and disease, determining a significant deterioration of frailty status both in infected and non-infected subjects

Effect of Lactoferrin on Clinical Outcomes of Hospitalized Patients with COVID-19: The LAC Randomized Clinical Trial

: As lactoferrin is a nutritional supplement with proven antiviral and immunomodulatory abilities, it may be used to improve the clinical course of COVID-19. The clinical efficacy and safety of bovine lactoferrin were evaluated in the LAC randomized double-blind placebo-controlled trial. A total of 218 hospitalized adult patients with moderate-to-severe COVID-19 were randomized to receive 800 mg/die oral bovine lactoferrin (n = 113) or placebo (n = 105), both given in combination with standard COVID-19 therapy. No differences in lactoferrin vs. placebo were observed in the primary outcomes: the proportion of death or intensive care unit admission (risk ratio of 1.06 (95% CI 0.63-1.79)) or proportion of discharge or National Early Warning Score 2 (NEWS2) ≤ 2 within 14 days from enrollment (RR of 0.85 (95% CI 0.70-1.04)). Lactoferrin showed an excellent safety and tolerability profile. Even though bovine lactoferrin is safe and tolerable, our results do not support its use in hospitalized patients with moderate-to-severe COVID-19

Higher Animal-Derived Dietary Protein Intake is Associated with Lower Prevalence of Frailty

Background: It is accepted that malnutrition is involved in the pathophysiology of frailty. However, the relationship between dietary animal-derived protein (DAP) intake and the prevalence of frailty is still unclear. Using data from the FRAIL Project, we aimed to determine whether DAP consumption is associated with frailty in community-dwellers aged 65 years and older. Methods: In this cross-sectional study involving only participants older than 65 years, DAP intake was evaluated through specific items of the Mini-Nutritional Assessment (MNA). Frailty statuswas assessed according to the Cardiovascular Health Study (CHS) model, which consists of five items (unintentional weight loss, weakness, slow gait speed, exhaustion, low physical activity). Frailty was defined as the presence of at least 3 criteria, and pre-frailty as the presence of 1 or 2. Results: Among the 407 participants enrolled (mean age 77.9 4.5 years; 51.6%women) the prevalence of frailty was 9.3%, and of pre-frailty 26.5%. Daily DAP consumption was reported by 206. Multinomial logistic regression analysis, adjusted for potential confounders, showed that higher DAP intake was associated with a significant reduction in frailty (odds ratio, OR = 0.41; 95% confidence intervals, CIs: 0.160.98) and pre-frailty (OR = 0.46; 95%CI: 0.270.79). Conclusion: Daily animal protein intake is associated with a lower prevalence of frailty in communitydwelling older subjects, suggesting that a diet rich in animal proteins could be useful in preventing frailty. Simple specific questions drawn fromtheMNAmay be an effective tool to gather useful information on protein consumption in elderly people and on their nutritional risk of being frail

Frailty trajectories in community‐dwelling older adults during COVID ‐19 pandemic: The PRESTIGE study

Background Frailty has been recognized as potential surrogate of biological age and relevant risk factor for COVID-19 severity. Thus, it is important to explore the frailty trajectories during COVID-19 pandemic and understand how COVID-19 directly and indirectly impacts on frailty condition. Methods We enrolled 217 community-dwelling older adults with available information on frailty condition as assessed by multidimensional frailty model both at baseline and at one-year follow-up using Multidimensional Prognostic Index (MPI) tools. Pre-frail/frail subjects were identified at baseline as those with MPI score >0.33 (MPI grades 2-3). Frailty worsening was defined by MPI difference between 12 months follow-up and baseline >= 0.1. Multivariable logistic regression was modelled to identify predictors of worsening of frailty condition. Results Frailer subjects at baseline (MPI grades 2-3 = 48.4%) were older, more frequently female and had higher rates of hospitalization and Sars-CoV-2 infection compared to robust ones (MPI grade 1). Having MPI grades 2-3 at baseline was associated with higher risk of further worsening of frailty condition (adjusted odd ratio (aOR): 13.60, 95% confidence interval (CI): 4.01-46.09), independently by age, gender and Sars-CoV-2 infection. Specifically, frail subjects without COVID-19 (aOR: 14.84, 95% CI: 4.26-51.74) as well as those with COVID-19 (aOR: 12.77, 95% CI: 2.66-61.40, p = 0.001) had significantly higher risk of worsening of frailty condition. Conclusions Effects of COVID-19 pandemic among community-dwelling frailer individuals are far beyond the mere infection and disease, determining a significant deterioration of frailty status both in infected and non-infected subjects